Improvements in prosthetic intervertebral disc and joint replacement components, and related surgical procedures, have led to dramatic increases in implant longevity. Many artificial hip and knee components now last for twenty years or more due to improved materials and greater insight into movement, load distribution and wear characteristics.
Many spinal conditions, including degenerative disc disease, can now be treated through artificial disc replacement (ADR), which has several advantages over spinal fusion. The most important advantage of ADR is the preservation of spinal motion. Spinal fusion eliminates motion across the fused segments of the spine. Consequently, the discs adjacent to the fused level are subjected to increased stress, which increases the changes of future surgery to treat the degeneration of the discs adjacent to the fusion.
One of the most important features of an artificial disc replacement (ADR) is its ability to replicate the kinematics of a natural disc. ADRs that replicate the kinematics of a normal disc are less likely to transfer additional forces above and below the replaced disc. In addition, ADRs with natural kinematics are less likely to stress the facet joints and the annulus fibrosus (AF) at the level of the disc replacement. Replicating the movements of the natural disc also decreases the risk of separation of the ADR from the vertebrae above and below the ADR.
The kinematics of joint replacements in general and ADRs in particular are governed by range of motion (ROM), the location of the center(s) of rotation (COR), and other such considerations. Clearly any improvements in these and other areas would be welcomed by the medical community and by patients undergoing procedures to implant prosthetic components of this kind.